Individual
MARY WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
1504 YANKEE PARK PL, DAYTON, OH 45458-1878
(937) 424-3068
(937) 496-5401
Mailing address
1504 YANKEE PARK PL, DAYTON, OH 45458-1878
(937) 424-3068
(937) 496-5401
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
RN317029
OH
363L00000X
Nurse Practitioner
Primary
COA.18775-NP
OH
Other
Enumeration date
04/27/2015
Last updated
08/29/2022
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